The Hunger Artist

When the phone hadn't sounded by 9 a.m., Gail Krasnow expected the worst. It was a practiced ritual, this daily phone call, born of a life-and-death struggle between mother and son that had continued for fourteen years. She could have given up on Michael years before. She could have tried to live a normal life. But he was her cherished child, and she wouldn't let him go, not without her best and most enduring fight. The morning before, Michael had called as planned. His voice was weak, his breathing short and labored. Was this the day she'd dreaded all these years, the day he'd coldly promised would come?

Her patience exhausted, she broke protocol and called his apartment. The phone, which wasn't hooked up to an answering machine, rang and rang. Michael Krasnow wasn't picking up. Mrs. Krasnow got up from her desk and headed for his apartment, located just a couple hundred yards from her office on Young Circle in Hollywood. After parking in the lot on Polk Street, she hurried through the Town House Rentals lobby to the elevator, stepped inside and punched the button for the eleventh floor, just one down from the top. Slowly the clanking, rumbling elevator climbed, 3... 4... 5... 6.... Finally, after nearly a full minute of tremulous ascent, the 11 lit, and the door slid open. She turned left past rooms M and L, past the "Trash" and "Storage" rooms to the final room at the end of the hall, Michael's room, Room J. Knocking with her left hand, she turned the silver-colored knob with her right.

Unlocked. Michael never kept his door unlocked, neither when he was home nor when he wasn't -- except when he was on the other end of the hall washing his clothes. Let it be the laundry, she hoped, as she opened the door to the little one-room apartment.

Inside he was lying still on a bed that also served as a couch. His sunken eyes were open in a dead man's stare. The skin was stretched even more tightly than usual on his skeletal face. "Oh no!" the mother cried. Mrs. Krasnow, widowed eight years before, put her hand on her son's stick-like, withered arm. It was cold, not too cold, but cold enough. There could be no mistake.

He'd won. After all those years fighting doctors, fighting her, fighting his own bodily instincts, and failing to get better, he'd finally achieved fatal starvation. Twenty-eight-year-old Michael Krasnow's final weight, as documented by the Broward County medical examiner's office, was 64 pounds. He was five-foot-ten.

The natural assumption by strangers when they saw him was that he was suffering from AIDS. He wasn't. Krasnow himself, not a virus, was at the controls of this suffering. His disease, though, was no less mysterious than HIV; his ailment was just as baffling as any microscopic ravager. He was anorexic. Anorexia nervosa. A disorder originating in the mind and manifesting itself in bones protruding from skin.

During his final years, he weighed between 70 and 75 pounds, a weight doctors told him would quickly precipitate his death. Krasnow solved that problem by quitting doctors. He often worked 40 hours a week at that weight, running the family finance company near his Hollywood apartment, where he'd retreated to live, and to die.

Covering his skin and bones in that apartment on the morning of October 9, 1997, the morning his mother found him dead, was one of his T-shirts, the one with a map of the Boston Marathon on it, and a pair of blue shorts. He wore only T-shirts, a jacket he'd had since he was a child, and a pair of bathrobes reduced to rags. For long pants he wore only a pair of pajama bottoms. The only suit he owned was the one he got at the age of thirteen for his bar mitzvah. When he wore it to a wedding not long before starving to death, it looked oversize on him, draping down from his stick-like limbs as if it were on a scarecrow.

In his room was an alarm clock, a watch, a phone, a small black-and-white TV, and a word processor. He never used the alarm clock or wore the watch. The phone was there at the insistence of his mother, who paid the bill so he'd keep it. The TV was turned on only occasionally, his mother said, "for the noise more than anything else." The word processor was there to type up the hand-written pages of his book, aptly titled My Life as a Male Anorexic. Straightforward and well-written, it remains the only known autobiography of a male anorexic ever published.

On his table was a letter to a professor at a Texas university who was interested in incorporating his book into her "body image" class. On the same table were two pieces of notebook paper lined with tiny, excruciatingly neat cursive handwriting, not a blemish on either page, not a single erasure or crossed out word, perfect. The two pages encompass "The Final Epilogue" and are meant to finish the book, which could use some extra bulk. At 81 pages minus the epilogues and addendums, the autobiography is about as thin as he was.

In it he lists some of the habits that helped make him an anorexic's anorexic, a king of starvation. Like most anorexics he had a drive to excel at fasting, to be the thinnest anorexic of all. What separated Krasnow from many of the others was that he truly had the strength of will to reach unbelievably low weights, and he had the constitution to function at them. These are some of the habits that set him apart, that made him the most devout anorexic his doctors had ever seen:

1.He never drank a drop of water in the fourteen years he was anorexic because he thought it would make it too easy to go without food if he was gorging himself on water. To him, drinking water would nullify his power of will.

2.He refused to swallow his own saliva, opting instead to carry a cup or paper towel with him everywhere he went to spit it into. He even kept something to spit into at his bedside while he rested.

3.While most anorexics eat low-calorie foods, Krasnow consumed small portions of fattening foods like peanut butter, for the same reason he didn't drink water -- to show himself that he was a first-rate anorexic.

His book wasn't a self-published vanity; Krasnow did more than just write about himself. It is essentially an indictment of the eating disorders treatment industry, a conviction of the doctors and psychiatrists he believed failed him miserably. He chronicles his journey from a confused boy "willing to do anything" a doctor or psychiatrist told him to do, to a young man hell-bent on starving himself to death and ultimately willing to fight bloody battles with doctors who tried to force him to eat. His story sheds light on the individual and systemic failures in the medical treatment of eating disorders, from the lack of comprehensive help available for most male anorexics, to the fact that some of the best specialists won't see the most dire patients, to the domineering methods of many psychiatrists that can backfire horrifically.

While doctors failed to save Krasnow, those close to him wonder if anything ever really could have helped him. Theodore E. Spielberg, one of the few doctors who ever gained Krasnow's respect, said the challenge in treating Krasnow was more than trying to get him to eat -- it was trying to get him to feel. He describes Krasnow's life condition as "total anhedonia," or the complete shutdown of anything that could cause him joy.

"I have never seen that in any other patient," Spielberg said. "He lived like a monk. He's an extraordinary case. I put the anorexia under the anhedonia. He just had no emotions, no feelings."

A true nothing man, a lifeless void, a walking skeleton, his face little more than a thin casing around his skull, the eyes framed in grotesquely visible sockets sunken deep behind sharp-jutting cheekbones. His massive-looking chin chiseled upward into his angular jawbone, also eerily prominent. His bony nose stuck out like a beak. Each of his ribs could be counted. His tiny shoulders were but a crux of pointy bones. His stomach sank down into his hip bones, the girdle under his torso like a huge salad bowl. His buttocks didn't exist.

He was so emaciated, it seemed he occupied a separate plane of existence, one teetering between life and death. He might fall to either side, depending on which way the wind blew.

Spielberg said he grew emotionally attached to Krasnow only through his own projection of emotions onto him, through bringing an imaginary light to those dead eyes. He wonders if anything could have been done to prevent those eyes -- once bright with boyhood -- from dying so many years before Krasnow did.

He called his own childhood typical. Krasnow was born in Rochester, New York, on April 27, 1969, and raised in Framingham, the son of a salesman father and a homemaker mother.

"I enjoyed being with my friends and family, loved to read and play sports, had a hobby (comic books) and a newspaper route, watched TV, idolized Larry Bird and Boston Celtics, and had no worries," he wrote.

Mrs. Krasnow fondly remembers her son, dripping from sweat after running and playing, wrapping his wet, affectionate arms around her. She also remembers a house full of friends playing and laughing. The pictures in her many family albums show a happy, healthy boy with a face dominated by a big smile, the eyes gleaming with pure joy.

Only one childhood trait seemed unusual to Michael as he looked back at his life: "I felt fat from as early as age eleven... When I speak of feeling fat, what I mean is that when I look down at my stomach, I see it as sticking out or being bloated."

Though he was already rail-thin, "sucking in my gut became a way of life." It may or may not have stunted his earliest attempts to form relationships with girls.

I occasionally danced with a girl my age, but not too often. Not that I didn't want to, I just lacked confidence around girls -- was too shy and too scared to ask. Because of the shyness, the fear, and the embarrassment caused by having someone's hands around my waist, I just decided not to dance.

Actually, feeling fat may not have had anything to do with my reluctance to dance. After all, I could have simply sucked in my gut.... I mean, I really, really wanted to. I was just too scared to ask, too scared that the girl would say no, and I'd feel foolish.

While girls were difficult for him to embrace, he found contentment on the basketball court. In hindsight his mother believes Michael's almost constant basketball playing might have been the first sign of his obsessiveness. He was also consumed with collecting things -- especially comic books -- a habit common to obsessive-compulsives.

While the life he wound up leading might presuppose bad and possibly abusive parents, his were, by all accounts, better than good. His father, Jerry Krasnow, was a born family man, enjoying immense amounts of time with both Michael and his older brother Neil, who now lives in Miami and works as a stage manager at a playhouse. His father "would drive me all over Massachusetts to different stores and conventions," Krasnow wrote, "not because he was fond of comic books, but because he knew how much I enjoyed them."

Gail Krasnow was a PTA president, the more practical parent, "getting me ready for school... helping with my homework, driving me anywhere I needed or wanted to go, etc., etc. She was the one who kept the family in line."

Mrs. Krasnow, who now lives in a high-rise apartment overlooking the Intracoastal Waterway in Hallandale, has searched her family history to find some genetic clue to her son's malady. Sitting in her immaculate, white-tiled living room, she explains that it may have its roots in her mother's side of the family, where one distant cousin has "problems," including "talk of possible anorexia," and another battled depression and drug and alcohol problems. Her own mother had signs of obsessive-compulsion, too: She habitually checked the stove to make sure it wasn't burning.

She calls Michael her "dream child," uncomplaining, highly affectionate, helpful in every way. He was modest, hated the popularity he got in elementary school when he landed the part of teen idol Shaun Cassidy in the school play, and hated to ride in his mother's used Lincoln Continental because he thought it made him look too rich, one of the earliest omens he'd become what Spielberg called a "monk."

It wasn't until high school, at the age of fourteen, that Michael fell into the abyss that led to his death fourteen years later.

He began high school in fine form, studying more than the average student and joining the cross-country and basketball teams. Then a depression came, and as it worsened he found himself spending more and more time at home studying. He quit the teams and abandoned his newspaper route. His grandfather was gravely ill at the same time and would soon die. Doctors would later point to the death as a possible trigger to Krasnow's problems.

"I say otherwise," Krasnow wrote in his book, "but what do I know? Everyone else knows what I think better than I do."

He gradually worked up to studying every night until 2:30 a.m. Then, he started setting his alarm for 4 a.m. to study before school, cutting his sleep to less than two hours a night. As the obsession deepened, his handwriting got smaller and smaller on the page.

"The study was part obsession, part perfection," Krasnow wrote. "Every piece of homework had to be immaculate. For instance, my math homework could not have one little erasure mark. This meant I had to copy it four, five, or six times. This perfection was very frustrating. To vent this frustration, I began banging my head against the wall."

The head-banging frightened his parents. "I used to see it. It's a wonder [his head] didn't split open," his mother recalled.

She took her son to a psychiatrist. He was put on antidepressants, which he would take fruitlessly and with side effects like uncontrolled trembling, mental confusion, and cold sweats. An experiment with hypnosis failed. Finally his parents took him out of school, denying him the source of his obsession. That made room for a new, even more bizarre one: tooth-brushing. He'd brush for twelve hours a day.

"One day, I woke up and said to myself, 'Oh, gee, I don't want to brush my teeth all day. Well, hey, don't have anything to eat, your mouth won't get dirty, and you won't have to brush.'"

Krasnow by then had two common anorexic traits that fueled his disorder: chronic depression and an obsessive-compulsive disorder. He embraced anorexia with a special fervor, kicking it off with an eight-day fast, the last four spent in a hospital. His war with doctors -- and with life -- had begun.

Self-starvation has a long history, and until the 1800s, when anorexia nervosa was "discovered," fasting was often seen as admirable, even saintly. In From Fasting Saints to Anorexic Girls, two Dutch authors write of the Christian practice of fasting as a form of penance, a way of curbing earthly desires. Ascetic Buddhists and ancient mystics also fasted in their quest for purity.

In addition to its spiritual uses, self-starvation was a form of a freak-show brand of entertainment at the turn of the Twentieth Century. Fasting men had shows where they'd sit on a stage and... well, not eat, sometimes for as many as 40 days. One of the most famous of these men was Claude Seurat, a Frenchman who allegedly weighed 72 pounds, about what Krasnow weighed during his final years, but Krasnow was three inches taller.

In 1922 Franz Kafka wrote a story called "A Hunger Artist," about a fasting performer who starves himself to death in a cage at a circus. The character's last words -- which have prompted some historical scholars to posit that Kafka, who was notedly thin and obsessed with food himself, was really writing about anorexia: "You shouldn't admire [my fasting].... Because I have to fast, I can't help it."

In 1860 a French doctor named Louis-Victor Marce published a tract on patients who refused to eat. "If the food refusal continues, the physician should employ intimidation and even force," he wrote, adding that, when necessary, the mouth should be pried opened violently.

If Krasnow's experiences are any indication, the philosophy behind the treatment of anorexics hasn't essentially changed much since then. Psychiatrists and medical doctors often make demands on their patients to reach certain weights in a certain number of days, using forced feedings as a final resort. Krasnow complains in his book that doctors seemed more interested in breaking him than in fixing him.

In his very first stay in a psychiatric ward in July 1983, he was told, after those initial eight days of fasting, that either he eat 500 calories, or he'd be sent to a hospital for a forced feeding. "I ate that morning. I really tried," he wrote. But he managed to ingest only 400 calories and was shipped to the hospital. "To this day, I don't know why [the doctor] was not satisfied. Perhaps he wanted to immediately impress upon me that he was in control."

That first fast, that first skirmish with doctors, gave young Krasnow a sense of control, too: "I had the willpower to diet. I was the all-powerful Michael."

When a doctor first told him he had symptoms of anorexia nervosa, "I automatically labeled myself an anorexic," he wrote. "It's hard to explain, but it almost seemed 'glamorous' to me... I was special. The anorexia gave me an identity."

Though Krasnow embraced his disorder, he also wrote that he wanted to get better and believed doctors to be "miracle workers." He began seeing a psychiatrist who, in his book, is referred to as "Dr. P." (The publishing house refused to publish the doctor's name, and Michael's mother refused to name him, fearing Dr. P would sue.) The mysterious Dr. P had an opportunity to work with Krasnow while he was still young and malleable.

Dr. P, who is the star of a chapter titled "The Silent Psychiatrist," was chronically late, and once he arrived, the real insanity began:

A typical session would start with each of us saying hello. Then we would sit down and look at each other. After doing this for 50 minutes, he would tell me that my time was up, and I would leave. This is the truth. I'm serious. He was getting paid around 60 dollars per hour, and we were staring at each other. That's all. No talking.

His mother still fumes at that chapter, which came as a revelation to her. Michael complained at the time, but she and her husband were told by other doctors that the psychiatrist had a wonderful reputation. She was afraid if she took Dr. P out of the picture, her son might get even worse. "I didn't know where else to go." She now knows it was a mistake to keep him going to Dr. P for nearly three years, after which, Krasnow wrote, his "depression increased to the point where it could not get any worse. It never let up. I just wanted to die."

Compounding this failure was the fact that anorexia in males is an ignored or hidden malady, while the mainstream media trumpets the disorder as a female problem. Males do comprise only a tiny percentage of anorexics, but experts in the field universally believe many more male anorexics are out there, yet to be diagnosed. For diagnosed males, there are only a few residential treatment centers in the country for them, none in Palm Beach, Miami-Dade, or Broward counties. The Renfrew, Fort Lauderdale's only residential treatment center for those suffering with eating disorders, is exclusively for females, though it recently began treating males on an outpatient basis.

Krasnow managed to maintain a weight of between 110 to 120 pounds through the end of high school, terribly thin but not life-threateningly so. It was his father's life that was threatened: During Krasnow's senior year, his father was diagnosed with Lou Gehrig's disease, an incurable and fatal form of muscular dystrophy. The grim truth was that his father would die, maybe in a year, maybe in a decade.

When Michael started commuting from his parents' house to a nearby college in the fall of 1987, he dropped breakfast from his diet, causing his weight to plummet to 96 pounds. His parents committed him to the psychiatric ward at Emerson Hospital in Concord, Massachusetts. He was told he could leave if he got his weight back up to 100 pounds. Instead he decided to kill himself. "Now I was (and still am) too much of a coward to shoot or stab myself or anything like that. The only way I would commit suicide is to fast and starve myself to death," he wrote.

He gained the five pounds necessary to get out of the hospital, withdrew some cash from his bank account, bought a one-way Greyhound ticket to Orlando, and took off. Police were put on the case, and stories about him running away appeared in the Boston newspapers, but Michael made it to Orlando anyway. The next day he decided to take an Amtrak train back to Boston, taking his "chances with dying on the train," he wrote in a diary entry. "If I'm not dead when I get to Boston, I don't know what I'll do." Before getting on the train, he inexplicably called his parents, which led to police finding him and his return home.

"What I will say about those five days 'on the run' is that I had peace of mind," he wrote. "I felt better about myself than I had for years."

Back home he started starving himself again, and by March 5, 1988, he was down to 81 pounds, prompting his parents to commit him to Bournewood Hospital in Brookline, Massachusetts, where he refused to gain weight, yet maintained his 80 pounds. "We were at an impasse," he wrote. It was here he was first treated by a psychiatrist named Stephen Wiener, another of the select few medical professionals who gained Krasnow's respect.

Wiener had him transferred to the eating disorders unit at Children's Hospital in Boston. It would be his only stay at a residential treatment program designed for anorexics, and, at age nineteen, he was out of place, a young man among kids.

He did well there anyway, gradually bringing his weight up to 92 pounds. Not long after he reluctantly agreed to increase his daily caloric intake to 1750, he was told to increase again, to 2000. "The plan was for me to get up to 110 to 120 pounds. To me this was unthinkable." He began to consider running away. Any chance of success was shattered by an arbitrary two-month time limit the hospital set on stays in the residential center. He was told he would soon have to leave Children's. "This would mean starting all over... I felt overwhelmed. On May 24, I ran."

His escape led to more headlines in the Boston Globe, Boston Herald and Middlesex News. ("Parents fear for son who left hospital," read one; "'Troubled' teen flees hospital," went another.) This time he made it to North Carolina, where he checked into a hotel to starve himself to death. After seven days of total fasting (no liquids either), he was still alive. He called his parents and they came and got him.

"Yes, I agree with what you are now probably thinking -- my parents did not deserve to get stuck with me; I did not deserve to be given such great parents; and yes, I am a pathetic human being," he wrote.

Wiener had relatively little experience in treating patients with eating disorders, and he realized that Krasnow's life might hinge on finding an experienced specialist in eating disorders. He called the best in New England, only to be met with one of the most glaring failures of all, the one that keeps the worst patients safely away from some of the most prominent psychiatrists. The specialists, without exception, refused to see Krasnow because he didn't weigh enough, a paradox that infuriated Wiener. Each specialist insisted Krasnow get up to 100 pounds or more before they'd treat him, "as some rigid orientation of a safety margin for Michael," Wiener wrote in a special addendum to Krasnow's book, adding that it seemed a "self-selection by the experts to treat only those patients who were already willing to accept treatment." They didn't want even the threat of death -- the worst failure a psychiatrist can suffer -- on their hands, Wiener implies.

Krasnow, meanwhile, dropped down to a dangerous 74 pounds and was put in Newton-Wellesley Hospital in Newton, Massachusetts. He continued to refuse to eat after eight days of fasting, prompting doctors to hook him up to an IV, a move that led Krasnow to eat again voluntarily. Within a few days his weight was back up to 80 pounds. He agreed to undergo electroshock therapy, which helped his depression -- for a while. The depression returned as strong as ever, and the net result was his loss of valuable memory of his father's last days. His father died on July 7, 1988.

"I've told you how great my dad was, so I'm going to hate myself for saying this, but I don't miss him. I don't even think about him that much... I just don't care about anyone or anything."

What Krasnow forgot, his mother says, was that minutes after Jerry Krasnow died, Michael asked to be alone with him by his deathbed. "He told him he was going to get better," Gail Krasnow said.

Michael's final hospital story is the most harrowing -- and the most brutal. After returning home, he dropped back down to 74 pounds. On June 20, 1989, after discovering that he'd tied on fifteen pounds of ankle weights to trick her when she weighed him, his mother had him committed to Newton-Wellesley again. By June 28, 1990, he was down to 69 1/4 pounds. This time the gloves were off. On both sides. Krasnow was determined to die. Doctors were determined to see him eat.

The physicians tried to force-feed him by pushing a clear plastic tube up his nose, down through his nasal cavity and throat, and into his stomach. Krasnow ripped the tubes out of his nose, the first skirmish in a weeks-long battle:

June 30: Still resisting doctors' efforts, he weighs 67 3/4 pounds. July 2: Now at 67 pounds, the situation is critical. With Spielberg on vacation, a substitute doctor orders a forced feeding. The doctor, named only "Dr. V" in Krasnow's book, tried to shove the tubes down Krasnow's throat, but Krasnow refuses to swallow them. "Nine times he pushed them in and yanked them out. I started to cough up blood. Later the nurse would tell me, 'It was so gross that I had to turn away.'" His wrists were tied down and his head was restrained. Krasnow "was still able to shake his head from side to side violently enough to throw the feeding tube back up his throat from his stomach," Wiener later wrote of it.

July 3: Krasnow is winning. His weight: 66 1/4 pounds. He manages to yank the tube out another dozen times.

July 5: Krasnow's blood-sugar level drops so low he has a hypoglycemic attack and goes into respiratory arrest. His mother, sitting in a waiting room, hears the word "code" and runs to her son's room to see doctors trying to revive him. "I remember thinking my head was going to explode," she remembered. "They forced me into my chair. I screamed, 'Let him alone! Let him be at peace!' He'd been through so much already." He was revived and put into the intensive care unit.

July 7: As a last resort, Krasnow is put on TPN, which stands for total parenteral nutrition and involves a feeding tube being sewn into a vein in his neck. To keep him from pulling out this tube, casts are placed on both arms and his wrists are tied down. One of Krasnow's lungs collapses, perhaps as a result of the TPN, requiring another tube to be sewn into his chest for reinflation.

July 8: Another hypoglycemic attack leads to respiratory arrest, and again he is revived. He later remembered that while he was dreaming, he told himself: "Wait 24 hours to die." He wants to say goodbye to a cousin. His body is cannibalizing itself, causing extreme bone marrow deficiency and wreaking havoc on his liver.

July 10: Spielberg returns. The hypoglycemic attacks continue and Krasnow, covered in blankets because of severe hypothermia, drifts in and out of consciousness.

July 20: After days on the brink, doctors discuss sewing a feeding tube into Krasnow's stomach for more-direct feeding.

July 23: The tube in his lung causes an infection. Krasnow's temperature shoots up to 104 degrees. He receives antibiotic injections.

The feeding tube in Krasnow's neck was keeping him alive and talk of the stomach operation resumed. Finally, at the end of July, Krasnow agreed to drink a can of Ensure, a chocolate-flavored nutritional drink, that Spielberg had brought him. It was a moment his mother never forgot, watching him voluntarily eat again.

He got back up to 70 pounds, but his depression was still so severe that doctors again decided to give him electroshock therapy. In the middle of August, the electricity was pumped into him, and he reentered a mental cloud. He managed to recall telling a nurse he wouldn't eat or do anything she asked him to do unless she stopped treating him like a baby.

"I was the boss -- all-powerful and in control." The following year, after another failed attempt to starve himself to death left him at 68 pounds, Dr. Spielberg called a truce with him. Rather than commit him to a hospital, he let Krasnow bring his weight up on his own.

Thus freed Krasnow, at the age of 21, moved to Broward County to run his uncle's finance company. Despite the medically proven fact that starvation shrinks the brain, his mind was clear enough to run a complex company, and through his own studies and his days at college, he'd become an expert with both computer systems and tax laws.

There seemed to be hope after all.

What do you say to a man who looks like he might vaporize before your eyes? For many years any trace of fat and muscle was impossible to find on Krasnow. But even more disturbingly, so was any emotion. He barely looked human, and he certainly didn't act like one. One relative wouldn't go to see him. "What are we going to talk about?" he'd say.

Even his mother had problems talking to the son she'd spent thousands of dollars and years of her life to help. Some days he simply didn't speak to her when she did visit, not a word, only leaden silence.

"I had to wrack my brains to come up with things to talk about," she said. All she wanted to get from her son was a reaction, a sign that he still had feelings. She never got it. The only emotion her son ever showed her in his last years was occasional anger, usually when he didn't agree with what she had said. When he had something to say, he would say it bluntly. When his mother would tell him she loved him, he'd calmly reply: "I'd believe you, if you didn't say it so much."

While she struggled with what to say to him, she knew exactly what not to say: Goodbye. She'd been told by one of her son's psychiatrists that to utter that word to him might give him license to commit suicide.

Gail Krasnow was both a cop and a spy when it came to her starving son. He hated to be checked up on, so she devised different ways to peek into his refrigerator, like bringing a bottle of water on her visits to put in his refrigerator. She didn't really need the water -- it was a pretense to scan the few things inside the fridge. On the rare occasions she found herself alone in his room, she'd pop through his cabinets to make sure he had food. Usually there would be a jar of peanut butter, some canned tuna and chicken, and cereal. He claimed to eat about 1000 calories a day in those last years, just enough to sustain his sparse weight. He wrote that in an average day, he would eat two ounces of cereal in milk in the morning, and a sandwich (peanut butter, tuna, or chicken) in the evening with a banana and juice.

His mother didn't want to push him into full rebellion, so she rarely tried to talk him into eating more. She knew how he reacted to doctors and their ultimatums and had learned lessons from it. His stone face never changed. Nothing could change him. So she walked on eggshells, hoping that whatever "clicked" in her son when he was fourteen years old would click back off. Now she wonders if she should have taken the opposite tack.

"I wonder what would have happened if I had screamed at him, 'If you want to kill yourself, go ahead and kill yourself!'" she now says with sorrow. "Maybe that would have worked. He would have amounted to quite a bit. If he married and had children... he would have made a wonderful parent. That'll never happen. I can't second-guess what's happened."

He wrote in his book that he spent most of his time, when he wasn't working, staring at the wall. Krasnow had absolutely no interests, not in politics, not in sports, not in art, not in sex, not in anything. During the months he wasn't working or writing his book, he vegetated in his apartment.

Krasnow lived mostly among retirees in his Hollywood apartment building. He'd occasionally walk through the dimly lit, brown-carpeted lobby in his ragged robes and pajama bottoms. People couldn't help but stare at him. It didn't seem to bother him. His mother was bothered. She'd glare right back at those curious and rude folks until they averted their eyes in embarrassment.

George Pettas, a 71-year-old retiree from New York City who lived in Krasnow's apartment building, often spoke to the ghostly man in their midst.

"What he had, it's all in the mind," explained Pettas, a former drummer in a jazz band, one recent afternoon in the Town House Rentals lobby. "He gave me a copy of his book, autographed it. He told everybody, 'I don't want to live.' I figure there's something wrong with his brain. Some people blow their brains out, jump out of a building, but him, he did it the hard way. It's a shame. He was determined to die. Oh yeah, he was absolutely looking forward to it. Most people didn't want to talk to him, he was so grotesque. What are you going to say to him? 'How are you?' He is looking like he's about to die. Oh, he was so pathetic. He looked worse than the guys in the concentration camps."

When Pettas heard that Krasnow had died, he said he felt relieved. Finally, an end to the suffering.

Gail Krasnow said she never really believed, despite her son's constant refrain that he would someday starve himself to death, that he'd ever actually do it. She thought he'd eventually settle into a career. If only she could have lifted the pall from his face. Could have watched him eat a steak dinner. Could have seen a smile break on his face. Or more than a smile. She recalls the times when Michael, as a boy of seven or eight years, would sit in front of the TV. "You'd hear this laugh that came from way down in him. A big, big belly laugh," she remembers. During his final years, she'd sometimes say to him: "If only I could hear you laugh like that again, it would make me so happy."

Michael wouldn't answer her. Just stared off into space, like that October morning she found his corpse on the couch.

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She hoped to find answers in those two hand-written pages, "The Final Epilogue." She didn't.

In his first epilogue, written after Haworth Press agreed to publish his book, Krasnow wrote that nothing had changed since he had written it a year earlier: "I still exist, but nothing else; as I've said all along, it's only a matter of time until I fast and starve myself to death." The second epilogue was written at the behest of his editors, who wanted him to include a sample menu, which he begrudgingly did.

The last epilogue was written on October 6, three mornings before his mom found him dead. He began it with words of hope for male anorexics, and he makes a kind of peace with the medical profession:

"You see, I'm not trying to discourage anyone, or to suggest that there is no hope... [W]hen I say I don't believe doctors are helpful, this is just my opinion... [T]here are a lot of good doctors out there, and many people have benefited from them... Please understand, there is hope; you can get better.

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